tbuckley/cabot-search huggingface dataset:
Effect of an Exclusive Human Milk Diet on the Gut Microbiome in Preterm Infants
Authors: Nicholas D. Embleton, Thomas Sproat, Sabita Uthaya, Gregory R. Young, Shalabh Garg, Vimal Vasu, Andrea C. Masi, Lauren Beck, Neena Modi, Christopher J. Stewart, Janet E. Berrington
Journal: JAMA Network Open (2023)

The effect of using an exclusive human milk diet compared with one that uses bovine products in preterm infants is uncertain, but some studies demonstrate lower rates of key neonatal morbidities. A potential mediating pathway is the gut microbiome.To determine the effect of an exclusive human milk diet on gut bacterial richness, diversity, and proportions of specific taxa in preterm infants from enrollment to 34 weeks' postmenstrual age.In this randomized clinical trial conducted at 4 neonatal intensive care units in the United Kingdom from 2017 to 2020, microbiome analyses were blind to group. Infants less than 30 weeks' gestation who had only received own mother's milk were recruited before 72 hours of age. Statistical analysis was performed from July 2019 to September 2021.Exclusive human milk diet using pasteurized human milk for any shortfall in mother's own milk supply and human milk-derived fortifiers (intervention) compared with bovine formula and bovine-derived fortifier (control) until 34 weeks' postmenstrual age. Fortifier commenced less than 48 hours of tolerating 150 mL/kg per day.Gut microbiome profile including alpha and beta diversity, and presence of specific bacterial taxa.Of 126 preterm infants enrolled in the study, 63 were randomized to control (median [IQR] gestation: 27.0 weeks [26.0-28.1 weeks]; median [IQR] birthweight: 910 g [704-1054 g]; 32 [51%] male) and 63 were randomized to intervention (median [IQR] gestation: 27.1 weeks [25.7-28.1 weeks]; median [IQR] birthweight: 930 g [733-1095 g]; 38 [60%] male); 472 stool samples from 116 infants were analyzed. There were no differences in bacterial richness or Shannon diversity over time, or at 34 weeks between trial groups. The exclusive human milk diet group had reduced relative abundance of Lactobacillus after adjustment for confounders (coefficient estimate, 0.056; P = .03), but not after false discovery rate adjustment. There were no differences in time to full feeds, necrotizing enterocolitis, or other key neonatal morbidities.In this randomized clinical trial in preterm infants using human milk-derived formula and/or fortifier to enable an exclusive human milk diet, there were no effects on overall measures of gut bacterial diversity but there were effects on specific bacterial taxa previously associated with human milk receipt. These findings suggest that the clinical impact of human milk-derived products is not modulated via microbiomic mechanisms.ISRCTN trial registry identifier: ISRCTN16799022.
Real‐Time Monitoring and Early Warning of a Cytokine Storm In Vivo Using a Wearable Noninvasive Skin Microneedle Patch
Authors: Jingxian Xu, Bin Yang, Jilie Kong, Yongjun Zhang, Xueen Fang
Journal: Advanced Healthcare Materials (2023)

Abstract A cytokine storm may be the last attack of various diseases, such as sepsis, cancer, and coronavirus disease 2019, that can be life threatening. Real‐time monitoring of cytokines in vivo is helpful for assessing the immune status of patients and providing an early warning of a cytokine storm. In this study, a functional carbon nanotube biointerface‐based wearable microneedle patches for real‐time monitoring of a cytokine storm in vivo via electrochemical analysis are reported. This wearable system has sensitivity with a detection limit of 0.54 pg mL −1 , high specificity, and 5 days of stability with a coefficient of variation of 4.0%. The system also has a quick response of several hours (1–4 h) to increasing cytokines. This wearable microneedle patch may offer a promising route for real‐time biomolecule wearables construction. The patch is also the first reported integrated capture and monitoring system that is capable of real‐time measurement of protein markers in interstitial fluid.
Association of Interparental Violence and Maternal Depression With Depression Among Adolescents at the Population and Individual Level
Authors: Dawid Gondek, Laura D. Howe, Ruth Gilbert, Gene Feder, Emma Howarth, Jessica Deighton, Rebecca E. Lacey
Journal: JAMA Network Open (2023)

Parental intimate partner violence (IPV) and maternal depression are associated with increased risk of depression in children at the population level. However, it is not known whether having information about these experiences can accurately identify individual children at higher risk of depression.To examine the extent to which experiencing parental IPV and/or maternal depression before age 12 years is associated with depression at age 18 years at the population and individual level.This cohort study used data from the Avon Longitudinal Study of Parents and Children, a UK population-based birth cohort, which initially recruited pregnant mothers with estimated due dates in 1991 and 1992. Data used in this study were collected from 1991 to 2009. Data analysis was performed from February to March 2022.Mother-reported parental IPV was assessed on 8 occasions (child age, 1-11 years). Maternal depression was assessed via the Edinburgh Postnatal Depression Scale or by the mother taking medication for depression, as reported by the mother on 8 occasions (child age, 2-12 years).Depressive symptoms were measured with the Short Mood and Feelings Questionnaire (SMFQ) and Clinical Interview Schedule-Revised (CIS-R) when the child was aged 18 years. Binary indicators of a case of depression were derived the cutoff point of 11 points or above for the SMFQ and 12 points or above for the CIS-R.The study included 5029 children (2862 girls [56.9%]; 2167 boys [43.1%]) with a measure of depressive symptoms at age 18 years. IPV only was associated with a 24% (adjusted risk ratio, 1.24; 95% CI, 0.97-1.59) higher risk of depression at age 18 years, exposure to maternal depression only was associated with a 35% (adjusted risk ratio, 1.35; 95% CI, 1.11-1.64) higher risk, and exposure to both IPV and maternal depression was associated with a 68% (adjusted risk ratio, 1.68; 95% CI, 1.34-2.10) higher risk. At the individual level, the area under the receiver operating characteristic curve was 0.58 (95% CI, 0.55-0.60) for depression according to the SMFQ and 0.59 (95% CI, 0.55-0.62) for the CIS-R, indicating a 58% to 59% probability (ie, 8%-9% above chance) that a random participant with depression at age 18 years had been exposed to IPV and/or maternal depression compared with a random participant who did not have depression.In this cohort study, parental IPV and maternal depression were associated with depression in adolescence at the population level. However, estimation of an individual developing depression in adolescence based only on information about IPV or maternal depression is poor. Screening children for maternal depression and IPV to target interventions to prevent adolescent depression will fail to identify many children who might benefit and may unnecessarily target many others who do not develop depression.
Nursing Homes Required to Reveal Ownership Status Under Proposed Rule
Authors: Emily Harris
Journal: JAMA (2023)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Using Diffuse Reflectance Spectroscopy to Classify Tumor Tissue in Upper Gastrointestinal Cancers—Reply
Authors: Scarlet Nazarian, Ioannis Gkouzionis, Christopher J. Peters
Journal: JAMA Surgery (2023)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Surgery HomeNew OnlineCurrent IssueFor Authors Podcast Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Surgery journal
Performance of the European Society of Cardiology 0/1-Hour Algorithm With High-Sensitivity Cardiac Troponin T Among Patients With Known Coronary Artery Disease
Authors: Nicklaus P. Ashburn, Anna C. Snavely, James C. O’Neill, Brandon R. Allen, Robert H. Christenson, Troy Madsen, Michael R. Massoomi, James K. McCord, Bryn E. Mumma, Richard Nowak, Jason P. Stopyra, Maite Huis in’t Veld, R. Gentry Wilkerson, Simon A. Mahler
Journal: JAMA Cardiology (2023)

Importance The European Society of Cardiology (ESC) 0/1-hour algorithm is a validated high-sensitivity cardiac troponin (hs-cTn) protocol for emergency department patients with possible acute coronary syndrome. However, limited data exist regarding its performance in patients with known coronary artery disease (CAD; prior myocardial infarction [MI], coronary revascularization, or ≥70% coronary stenosis). Objective To evaluate and compare the diagnostic performance of the ESC 0/1-hour algorithm for 30-day cardiac death or MI among patients with and without known CAD and determine if the algorithm could achieve the negative predictive value rule-out threshold of 99% or higher. Design, Setting, and Participants This was a preplanned subgroup analysis of the STOP-CP prospective multisite cohort study, which was conducted from January 25, 2017, through September 6, 2018, at 8 emergency departments in the US. Patients 21 years or older with symptoms suggestive of acute coronary syndrome without ST-segment elevation on initial electrocardiogram were included. Analysis took place between February and December 2022. Interventions/Exposures Participants with 0- and 1-hour high-sensitivity cardiac troponin T (hs-cTnT) measures were stratified into rule-out, observation, and rule-in zones using the ESC 0/1-hour hs-cTnT algorithm. Main Outcomes and Measures Cardiac death or MI at 30 days determined by expert adjudicators. Results During the study period, 1430 patients were accrued. In the cohort, 775 individuals (54.2%) were male, 826 (57.8%) were White, and the mean (SD) age was 57.6 (12.8) years. At 30 days, cardiac death or MI occurred in 183 participants (12.8%). Known CAD was present in 449 (31.4%). Among patients with known CAD, the ESC 0/1-hour algorithm classified 178 of 449 (39.6%) into the rule-out zone compared with 648 of 981 (66.1%) without CAD ( P &amp;amp;lt; .001). Among rule-out zone patients, 30-day cardiac death or MI occurred in 6 of 178 patients (3.4%) with known CAD and 7 of 648 (1.1%) without CAD ( P &amp;amp;lt; .001). The negative predictive value for 30-day cardiac death or MI was 96.6% (95% CI, 92.8-98.8) among patients with known CAD and 98.9% (95% CI, 97.8-99.6) in patients without known CAD ( P = .04). Conclusions and Relevance Among patients with known CAD, the ESC 0/1-hour hs-cTnT algorithm was unable to safely exclude 30-day cardiac death or MI. This suggests that clinicians should be cautious if using the algorithm in patients with known CAD. The negative predictive value was significantly higher in patients without a history of CAD but remained less than 99%.
Study: Breast Radiotherapy Does Not Improve Survival in Older Patients
Authors: Emily Harris
Journal: JAMA (2023)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Endoscopic ultrasound-guided rendezvous in pancreas divisum with a nondilated pancreatic duct
Authors: Marzieh Jamali, Mehdi Mohamadnejad
Journal: Endoscopy (2023)

Pancreas divisum is the most common congenital malformation of the pancreas, in which a single pancreatic duct does not form in the 7th week of gestation. It usually causes no symptoms or complications, but a small percentage of persons with this malformation develop recurrent acute pancreatitis. Patients with recurrent acute pancreatitis may benefit from endoscopic sphincterotomy of the minor papilla to open up the outflow of the dorsal pancreatic duct [1] [2].
Gel immersion cannulation during hemostasis of post-endoscopic sphincterotomy bleeding
Authors: Kazuki Hama, Haruka Toyonaga, Kosuke Iwano, Tatsuya Ishii, Toshifumi Kin, Tsuyoshi Hayashi, Akio Katanuma
Journal: Endoscopy (2023)

Post-endoscopic sphincterotomy (ES) bleeding is a common complication of biliary sphincterotomy. The rate of post-ES bleeding varies widely and bleeding may present immediately or several days later. Endoscopic hemostasis includes injection, thermal coagulation, and mechanical methods, either alone or in combination. Vascular embolization or surgery is necessary when hemostasis is difficult to achieve [1].
Direct anorectal intubation during colonoscopy: a logical new paradigm
Authors: Alvaro Martínez-Alcalá, Kiril Manovski, Klaus Mönkemüller
Journal: Endoscopy (2023)

Traditionally, endoscopists are trained to introduce the colonoscope blindly through the anus using the finger as a guide, and then start the mucosal inspection [1]. This practice of blindly introducing the tip of the scope originated during the era of fiberoptic endoscopy, but has remained standard despite the availability of wide-angle viewing video colonoscopy techniques, which practically allow for a complete and detailed inspection of the perineal and anal areas. Indeed, video gastroscopes were also inserted blindly into the esophagus until the last century. Nevertheless, now it is standard to insert video gastroscopes under direct vision and inspect the hypopharynx and vocal cord areas as well.
A novel technique of endoscopic introducer-assisted transpapillary gallbladder aspiration prior to drainage in a patient with acute cholecystitis
Authors: Tesshin Ban, Yoshimasa Kubota, Kazuki Hayashi, Takuya Takahama, Shun Sasoh, Tomoaki Ando, Takashi Joh
Journal: Endoscopy (2023)

Endoscopic transpapillary gallbladder drainage (ET-GBD) is the preferred technique in patients with acute cholecystitis and cholangitis [1]. Meta-analyses have reported technical and clinical success rates of 83 % and 88.1 % respectively [1] [2]. Aspiration of the infected bile and saline irrigation using nasobiliary drainage is an acceptable method [1]; however, the performance of this maneuver during ET-GBD is time-consuming because of the high viscosity of the bile and the small caliber of the conventional endoscopic retrograde cholangiopancreatography catheter. Endoscopic introducer-assisted procedures have recently emerged as effective pancreaticobiliary interventions [3] [4]. This article describes gallbladder aspiration and irrigation using a novel dual-structure catheter.
Management of multiple esophageal leaks with an ultra-large fully covered metallic stent after aborted peroral endoscopic myotomy
Authors: Ana Lorena Madrigal Méndez, Daniela Grant, Viviana Hernández, Kenneth Ernest-Suárez, Jorge Vargas-Madrigal, Luis Diego Arguedas, Álvaro Villalobos
Journal: Endoscopy (2023)

Aborted peroral endoscopic myotomy (POEM) is rare, and submucosal fibrosis is the most common direct cause of technical failure [1] [2]. Age, disease duration, sigmoid esophagus, and prior interventions are the main risk factors for submucosal fibrosis [2] [3].
Inner countertraction facilitating endoscopic submucosal dissection of a difficult early gastric cancer independent of transparent cap
Authors: Zhi-hui Wang, Xiang-rong Zhou, Wei-hui Liu
Journal: Endoscopy (2023)

Endoscopic submucosal dissection (ESD) has been applied widely for treatment of early gastric cancer (EGC) [1]. However, for difficult locations, the submucosal vision is often unclear, resulting in prolonged operation time as well as increased risk of bleeding and perforation. Inner countertraction allows for safe and speedy dissection in the colon [2] but not in the stomach. Here, we developed a preliminary inner countertraction method to facilitate ESD of EGC in difficult locations ([Video 1]).
The prevalence, correlation, and co-occurrence of neuropathology in old age: harmonisation of 12 measures across six community-based autopsy studies of dementia
Authors: Emma Nichols, Richard Merrick, Simon I Hay, Dibya Himali, Jayandra J Himali, Sally Hunter, Hannah A D Keage, Caitlin S Latimer, Matthew R Scott, Jaimie D Steinmetz, Jamie M Walker, Stephen B Wharton, Crystal D Wiedner, Paul K Crane, C Dirk Keene, Lenore J Launer, Fiona E Matthews, Julie Schneider, Sudha Seshadri, Lon White, Carol Brayne, Theo Vos
Journal: The Lancet Healthy Longevity (2023)
Hydroxyurea with dose escalation for primary stroke risk reduction in children with sickle cell anaemia in Tanzania (SPHERE): an open-label, phase 2 trial
Authors: Emmanuela E Ambrose, Teresa S Latham, Primrose Songoro, Mwesige Charles, Adam C Lane, Susan E Stuber, Abel N Makubi, Russell E Ware, Luke R Smart
Journal: The Lancet Haematology (2023)
Nursing home crowding and its association with outbreak-associated respiratory infection in Ontario, Canada before the COVID-19 pandemic (2014–19): a retrospective cohort study
Authors: Pamela Leece, Michael Whelan, Andrew P Costa, Nick Daneman, Jennie Johnstone, Allison McGeer, Paula Rochon, Kevin L Schwartz, Kevin A Brown
Journal: The Lancet Healthy Longevity (2023)

Studies conducted during the COVID-19 pandemic have shown that crowding in nursing homes is associated with high incidence of SARS-CoV-2 infections, but this effect has not been shown for other respiratory pathogens. We aimed to measure the association between crowding in nursing homes and outbreak-associated respiratory infection incidence and related mortality before the COVID-19 pandemic.We conducted a retrospective cohort study of nursing homes in Ontario, Canada. We identified, characterised, and selected nursing homes through the Ontario Ministry of Long-Term Care datasets. Nursing homes that were not funded by the Ontario Ministry of Long-Term Care and homes that closed before January, 2020 were excluded. Outcomes consisting of respiratory infection outbreaks were obtained from the Integrated Public Health Information System of Ontario. The crowding index equalled the mean number of residents per bedroom and bathroom. The primary outcomes were the incidence of outbreak-associated infections and mortality per 100 nursing home residents per year. We examined the incidence of infections and deaths as a function of the crowding index by use of negative binomial regression with adjustment for three home characteristics (ie, ownership, number of beds, and region) and nine mean resident characteristics (ie, age, female sex, dementia, diabetes, chronic heart failure, renal failure, cancer, chronic obstructive pulmonary disease, and activities of daily living score).Between Sept 1, 2014, and Aug 31, 2019, 5107 respiratory infection outbreaks in 588 nursing homes were recorded, of which 4921 (96·4%), involving 64 829 cases of respiratory infection and 1969 deaths, were included in this analysis. Nursing homes with a high crowding index had higher incidences of respiratory infection (26·4% vs 13·8%; adjusted rate ratio per one resident per room increase in crowding 1·89 [95% CI 1·64-2·17]) and mortality (0·8% vs 0·4%; 2·34 [1·88-2·92]) than did homes with a low crowding index.Respiratory infection and mortality rates were higher in nursing homes with high crowding index than in homes with low crowding index, and the association was consistent across various respiratory pathogens. Decreasing crowding is an important safety target beyond the COVID-19 pandemic to help to promote resident wellbeing and decrease the transmission of prevalent respiratory pathogens.None.
The age-related contribution of cognitive function to dual-task gait in middle-aged adults in Spain: observations from a population-based study
Authors: Junhong Zhou, Gabriele Cattaneo, Wanting Yu, On-Yee Lo, Natalia A Gouskova, Selma Delgado-Gallén, Maria Redondo-Camós, Goretti España-Irla, Javier Solana-Sánchez, Josep M Tormos, Lewis A Lipsitz, David Bartrés-Faz, Alvaro Pascual-Leone, Brad Manor
Journal: The Lancet Healthy Longevity (2023)
Neoadjuvant PD-1 blockade with sintilimab in mismatch-repair deficient, locally advanced rectal cancer: an open-label, single-centre phase 2 study
Authors: Gong Chen, Ying Jin, Wen-Long Guan, Rong-Xin Zhang, Wei-Wei Xiao, Pei-Qiang Cai, Min Liu, Jun-Zhong Lin, Fu-Long Wang, Cong Li, Ting-Ting Quan, Shao-Yan Xi, Hui-Zhong Zhang, Zhi-Zhong Pan, Feng Wang, Rui-Hua Xu
Journal: The Lancet. Gastroenterology & hepatology (2023)